tbuckley/cabot-search huggingface dataset:
Endoscopic Retrograde Cholangiopancreatography
Authors: Rama P. Venu
Journal: JAMA (1983)

The combination of a normal oral cholecystogram and ultrasound study of the gallbladder is considered adequate evidence to exclude cholelithiasis as a cause of biliarylike pain. We examined 206 patients with biliarylike pain and normal findings on cholecystogram and ultrasound study of the gallbladder by endoscopic retrograde cholangiopancreatography (ERCP). Of the 195 patients who had successful ERCP, 32 patients (group 1) had mild, transient abnormalities in liver function tests and 163 (group 2) had normal liver function test results. Small gallstones were demonstrated on ERCP examination in 25 of 32 group 1 patients and in four of 163 group 2 patients, all confirmed at surgery or endoscopic sphincterotomy. In conclusion, despite negative results on cholecystogram and ultrasound study of the gallbladder, patients with biliarylike pain and abnormal liver function test results should be evaluated further by diagnostic ERCP examination. (<i>JAMA</i>1983;249:758-761)
Analysis of treatment in childhood leukaemia. I. Predisposition to methotrexate-induced neutropenia after craniospinal irradiation. Report to the Medical Research Council of the Working Party on Leukaemia in Childhood.
Journal: BMJ (1975)

The degree of drug-induced neutropenia resulting from a controlled trial (UKALL I) of treatment in acute lymphoblastic leukaemia was analysed. The main agent associated with severe neutropenia was methotrexate, and methotrexate-induced neutropenia was significantly greater in patients who had received craniospinal irradiation. The synergistic toxic effect of irradiation followed by methotrexate treatment seems to have contributed to three of the five deaths which occurred in complete remission in this trial; all deaths in remission occurred in patients who had received central nervous system prophylaxis. Analysis of patients who subsequently relapsed compared with those still in remission after 18 months of treatment indicated that the former, on average, had slightly lower neutrophil counts. This suggests that the children who relapsed did not receive any less aggressive treatment than those who remained in remission.
Minor Surgery.
Journal: JAMA (1928)

This was written as a practical help to the dispensary student. There are chapters on bandaging, sutures, dressings, hemorrhage, inflammation and infections. The common surgical conditions usually observed in a dispensary are discussed, including the diagnosis of a number of more serious major surgical conditions. The authors take up each region of the body separately, discussing each condition clearly and briefly, but with surprising little duplication of text. One feature is the reproduction of numerous photographs which illustrate the clinical material presented unusually well.
The electrocardiogram and coronary insufficiency
Authors: T. Winsor
Journal: JAMA (1968)

The exercise tolerance test is the most important of all widely employed office techniques for the detection and evaluation of coronary arteriosclerosis. A reliable sign of coronary insufficiency is the S-T segment abnormality occurring in the postexercise electrocardiogram indicating ischemia. The S-T segment shift refers to a horizontal flattening or sagging depression of the S-T segment induced by exercise. The depressions occur most often in lead V<sub>4</sub>or similar apical leads. They are produced usually by an amount of exercise equivalent to the double Master "two-step" exercise test, persist for more than one minute after the cessation of exercise, and are seen more easily with the patient in the supine position. The test is only reliable when the patient has not received digitalis for three weeks or quinidine for 24 hours prior to the test, or when hypokalemia, hypocalcemia, or hyperventilation are not present. The test can be interpreted
Momentum grows behind plans for health museum
Authors: R. Voelker
Journal: JAMA (1997)

FORMER Surgeon General C. Everett Koop, MD, and a group of supporters have envisioned a unique museum of health and medicine near the Mall in Washington, DC. Shortly before the holidays, the museum got a symbolic thumbs-up from Congress, with passage of the National Health Museum Development Act. The act, written by Sen Edward Kennedy (D, Mass) and Sen Orrin Hatch (R, Utah), guarantees a site on or near the Mall, and it establishes a commission to study and make recommendations on the appropriate federal role in eventual public-private partnerships that will build the museum. The legislation also provides $500 000 to support the commission's activities. Koop has called passage of the act "a tremendous victory for all Americans." He said that, when completed, the National Health Museum "will challenge the notion of what a museum can be and what it can do." Fitzhugh Mullan, MD, vice chair of the
Amiodarone in Patients with Heart Failure
Authors: G. Breithardt
Journal: New England Journal of Medicine (1995)

Two recent studies have suggested that amiodarone, a potent antiarrhythmic agent, is a promising drug for the treatment of ventricular tachyarrhythmias after myocardial infarction.1,2 The results of two additional studies of the use of amiodarone after myocardial infarction (the European Myocardial Infarct Amiodarone Trial and the Canadian Amiodarone Myocardial Infarction Arrhythmia Trial) will soon be reported.3,4 In this issue of the Journal, Singh and his coworkers report the results of the Veterans Affairs Survival Trial of Antiarrhythmic Therapy in Congestive Heart Failure.5 This trial examined the effect of amiodarone on mortality in patients with chronic congestive heart failure . . .
Structural Factors in the In Vivo Chelate Mobilization of Aged Cadmium Deposits
Authors: Pramod K. Singh, Shirley G. Jones, Mark M. Jones
Journal: Environmental Health Perspectives (1990)

The role of structural factors in determining the relative efficacy of dithiocarbamates as chelating agents for the in vivo mobilization of aged cadmium deposits is examined for 23 newly synthesized compounds of this type.The critical feature in determining the efficacy of the compounds in mobiliz- ing intracellular cadmium is the balance between hydrophobic and hydrophilic groups.This balance also governs the other properties of these compounds such as the organ specificity of action and the relative propensity to carry cadmium to the brain.The transport of cadmium to the brain by dithiocar- bamate can be greatly reduced by the incorporation of appropriate hydrophilic groups that prevent the formation of lipid-soluble cadmium complexes that pass readily into the brain.If the chelating agents carry an additional ionic charge, their ability to pass through cellular membranes and react with intracellular deposits of cadmium is significantly reduced, with other structural factors being equal.The structural features that optimize mobilization of cadmium from the kidney do not appear to be identical with those that optimize its mobilization from the liver.The correlation of cadmium- mobilizing properties of these chelating agents with the sum of the Hansch n constants for the parts of the molecular structures other than the dithiocarbamate grouping (lIn) is reasonably good for the removal of renal cadmium by derivatives of D-glucamine and D-xylamine.Another aspect of the molecular structure that appears to play a role is the presence of uncharged polar groups having the ability to form hydrogen bonds.The relevance ofthese factors in designing chelating agents to enhance the excretion of other toxic metals from their intracellular sites is discussed.
Silicone lymphadenopathy and synovitis. Complications of silicone elastomer finger joint prostheses
Authors: A. J. Christie
Journal: JAMA (1977)

We report two complications of silicone elastomer finger joint prostheses. In one patient, the prostheses broke, with silicone particles present in synovium ("detritic synovitis"). In another patient, silicone particles were found in an axillary lymph node five years after insertion of prostheses in the ipsilateral hand (prostheses were intact at the time). Microscopically, silicone particles in synovium and lymph node were identical to particles abraded from a new prosthesis. (<i>JAMA</i>237:1463-1464, 1977)
HOME CONDITIONS AND EYESIGHT
Authors: A. H. Thompson
Journal: BMJ (1909)

<h3>ABSTRACT</h3> The tropical and subtropical Andes have among the highest levels of biodiversity in the world. Understanding the forces that underlie speciation and diversification in the Andes is a major focus of research. Here we tested two hypotheses of species origins in the Andes: 1. Vicariance mediated by orogenesis or shifting habitat distribution. 2. Parapatric diversification along elevational environmental gradients. We also sought insights on the factors that impacted the phylogeography of co-distributed taxa, and the influences of divergent species ecology on population genetic structure. We used phylogeographic and coalescent analyses of nuclear and mitochondrial DNA sequence data to compare genetic diversity and evolutionary history of two frog species: <i>Pleurodema borellii</i> (Family: Leiuperidae, 130 individuals; 20 sites), and <i>Hypsiboas riojanus</i> (Family: Hyllidae, 258 individuals; 23 sites) across their shared range in northwestern Argentina. The two showed concordant phylogeographic structuring, and our analyses support the vicariance model over the elevational gradient model. However, <i>Pleurodema borellii</i> exhibited markedly deeper temporal divergence (≥4 Ma) than <i>H. riojanus</i> (1-2 Ma). The three main mtDNA lineages of <i>P. borellii</i> were nearly allopatric and diverged between 4-10 Ma. At similar spatial scales, differentiation was less in the putatively more habitat-specialized <i>H. riojanus</i> than in the more generalist <i>P. borellii</i>. Similar allopatric distributions of major lineages for both species implies common causes of historical range fragmentation and vicariance. However, different divergence times among clades presumably reflect different demographic histories, permeability of different historical barriers at different times, and/or difference in life history attributes and sensitivities to historical environmental change. Our research enriches our understanding of the phylogeography of the Andes in northwestern Argentina.
Capsule endoscopy
Authors: J.-C. Saurin
Journal: Endoscopy (2007)

Over the past 6 years or more, capsule endoscopy has emerged as a success story, not only in terms of its development for a variety of different indications and its use in different sites in the gastrointestinal tract, but also in that it has stimulated our thoughts on the optimal modern endoscopic work-up for each specific indication. This year at Digestive Disease Week there were around 77 abstracts concerned with capsule endoscopy. These included reports on the usefulness and safety of capsule endoscopy in different clinical situations, including obscure bleeding (for which capsule endoscopy now forms the basis of clinical management), Crohn’s disease, and the detection of small-bowel tumors (which can probably be regarded as a difficult application of capsule endoscopy); reports on topics specific to capsule endoscopy, such as the rationale for small-bowel preparation, the development of new capsules, technical (biochromoendoscopy) and software developments; and abstracts on the development of capsules designed specifically for different sites in the gastrointestinal tract (e. g. the Pillcam ESO in esophageal portal hypertension and the newer colon capsules). These numerous and interesting reports not only demonstrate the influence of capsule endoscopy on clinical management, but they also throw light on conventional endoscopy practices, including the rapid development of double-balloon enteroscopy, and the ongoing intense debate surrounding new methods for colonic neoplasia screening.
PTU-138 A randomised controlled trial of six weeks of home enteral nutrition versus standard care after oesophagectomy or total gastrectomy for cancer: report on a pilot and feasibility study
Authors: D Bowrey, M Baker, V Halliday, A Thomas, R Pulikottil-Jacob, K Smith, T Morris, A Ring
Journal: Gut (2015)

<h3>Introduction</h3> Poor nutrition in the first months after oesophagogastric resection may be one of the contributing factors to the reduced quality of life seen in these patients. The aim of this pilot and feasibility study was to ascertain the feasibility and potential benefit of home enteral nutrition to inform a subsequent multi-centre randomised controlled trial. <h3>Method</h3> Patients undergoing oesophagectomy/total gastrectomy were randomised to either 6 weeks of home jejunostomy feeding (intervention) or treatment as usual (control). The intervention (overnight feeding) provided 50% of energy and protein requirements. Primary outcome measures were recruitment and retention rates at 6 weeks and 6 months. Secondary outcome measures were quality of life, nutritional intake (baseline, hospital discharge, 6 weeks post hospital discharge, 3 and 6 months postoperatively) and healthcare costs. Purposive sampling of patients enrolled in the study was conducted so that interviews could be conducted with patient participants and their informal carers, in order to ascertain experiences of living with a jejunostomy tube and home feeding. <h3>Results</h3> 54 of 112 (48%) eligible patients participated in the study over the 20 months. Study retention at six weeks was 41/54 patients (76%) and at six months was 36/54 (67%). Operations were oesophagectomy (32 patients) and total gastrectomy (9 patients). Seventeen of the 20 participants (85%) in the intervention group received treatment as planned, while eight of the 21 (38%) participants in the control arm required rescue home enteral feeding. The pooled estimate of standard deviation for the EORTC QLQ C30 tool was 23 at three months after surgery, and for the OG25 tool, it was 15. The economic evaluation suggested that the mean healthcare costs associated with intervention were slightly less than usual treatment. The interview study revealed that participants described coping mechanisms for managing the feeding tube and high levels of compliance with both tube care and the feeding regimen. <h3>Conclusion</h3> In this pilot and feasibility study 90% of the target sample size was recruited, 48% of the eligible population, with a retention rate of 67% at six months. The intervention was acceptable to the participants. A large scale multi-centre study to fully evaluate this intervention should be feasible. <h3>Disclosure of interest</h3> D. Bowrey Grant/ Research Support from: Nutricia, Fresenius-Kabi, M. Baker: None Declared, V. Halliday: None Declared, A. Thomas Grant/ Research Support from: Fresenius-Kabi, R. Pulikottil-Jacob: None Declared, K. Smith: None Declared, T. Morris: None Declared, A. Ring: None Declared.
Abstract 4881: Interaction of Genetic and Pharmacologic <i>β</i> -adrenergic Signaling Inhibitors Determines Long-term Mortality after Acute Coronary Ischemia
Authors: Sharon Cresci, Reagan Kelly, Sharon Kardia, John A Spertus, Gerald W Dorn
Journal: Circulation (2008)

Introduction: While chronic β-blocker (BB) therapy after myocardial infarction (MI) reduces the long-term risk of death, recent studies suggest that BB within 24h after MI is associated with increased death from cardiogenic shock. We have described a naturally-occurring G-protein Receptor Kinase ( GRK )5 L41 polymorphism that mimics BB effects in experimental models and human heart failure raising the possibility that pre-existing “genetic β-blockade” might also affect outcomes after MI. Methods: 3,244 patients hospitalized with acute coronary ischemic syndromes (ACS; 2,943 MI; 301 unstable angina) were followed for an average of 2.7 years. Primary endpoint was time to death. A sub-cohort (n=973) was followed for time to rehospitalization. Independent variables were antecedent BB therapy (a-BB), discharge BB therapy (d-BB), and GRK5 Q41L genotype. Differences were assessed with Kaplan Meier curves, log-rank tests, and Cox proportional hazards modeling (HR). Results: Complete data were available for 2,732 subjects (24% African American [AA], 33% female, 32% a-BB, 87% d-BB). Overall mortality rate was 12%, and rehospitalization occurred in 41%. AA had increased mortality risk (HR=1.32, CI= 1.017–1.71, p=0.037). a-BB significantly increased mortality in both AA (HR=1.69, CI=1.006–2.84, p=0.047) and Caucasians (HR=1.98, CI=1.523–2.57, p=0.00000033). GRK5 L41 is more common in AA. GRK5 L41 carrier status did not significantly affect mortality in AA or Caucasian non-BB subjects, but protected against death in AA with a-BB (HR=0.456, CI= 0.256 – 0.812, p=0.0076; p value for gene-drug interaction=0.041). In the rehospitalization sub-study, GRK5 L41 protected AA from rehospitalization, independent of BB use (HR=0.605, CI=0.388 – 0.943, p=0.026). d-BB status was not associated with mortality or rehospitalization after discharge. Conclusions: Antecedent, but not discharge, treatment with BB is associated with adverse long-term outcomes in ACS patients requiring hospitalization. In contrast, AA patients carrying the GRK5 L41 polymorphism are protected against death and rehospitalization. “Genetic β-blockade” may have advantages over, and can oppose some untoward consequences of, pharmacological β-receptor antagonism in ACS patients.
Paris Workshop on Columnar Metaplasia in the Esophagus and the Esophagogastric JunctionParis, France, December 11 - 12 2004
Journal: Endoscopy (2005)

Foreword byProfessor Emeritus G. N. J. TytgatPresident of the World Gastroenterology Organisation (Organisation Mondiale de Gastro-Entérologie, OMGE)
Conundrum
Authors: Peter Glusker
Journal: Annals of Internal Medicine (2012)

Ad Libitum15 May 2012ConundrumPeter Glusker, MDPeter Glusker, MDFrom Fort Bragg, CA 95437.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-10-201205150-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Time treaclessticking in my joints and spinebut echoing the sweetness of the yearsbelying the price of creeping decrepitude.Peter Glusker, MDFort Bragg, CA 95437 Author, Article, and Disclosure InformationAffiliations: From Fort Bragg, CA 95437.Current Author Address: Peter Glusker, MD, PO Box 1639, Fort Bragg, CA 95437. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 May 2012Volume 156, Issue 10Page: 745KeywordsSpine ePublished: 15 May 2012 Issue Published: 15 May 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
US Cigarettes
Authors: Bridget M. Kuehn
Journal: JAMA (2010)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
"ECHTMAN'S RHINOPULMONARY REFLEX"
Journal: JAMA (1922)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Hospital variables associated with quality of care for breast cancer patients
Authors: R. Hand
Journal: JAMA (1991)

<h3>Objective.</h3> —To determine the degree of compliance with clinical standards among hospitals for care of breast cancer patients and account for variations in compliance. <h3>Design.</h3> —Analysis of cancer registry data submitted to the American Cancer Society, Illinois Division, Chicago, for a concurrent prospective descriptive study of breast cancer, supplemented by other hospital data from public sources. <h3>Setting.</h3> —Ninety-nine Illinois hospitals evenly distributed among rural counties, counties with small cities outside the Chicago metropolitan area, exurban counties in the Chicago metropolitan area, suburban Cook County, and urban Chicago. <h3>Patients.</h3> —A total of 5766 newly diagnosed patients with histologically confirmed breast cancer in 1988, representing 84% of the estimated 6900 new cases in the state for that year. <h3>Main Outcome Measures.</h3> —Descriptive statistics and multiple linear regression analyses of five dependent quality variables from clinical indicators related to early diagnosis, hormone receptor determination, adjuvant therapy, radiation therapy, and axillary lymph node dissection. <h3>Results.</h3> —At the hospitals studied, (1) late stage (IIb through IV) at diagnosis was associated with urban location, higher proportion of poorly insured patients, fewer breast cancer cases treated, and lower oncology charges (proportion of variance explained,<i>R</i><sup>2</sup>=.50,<i>P</i>&lt;.00001); (2) omission of hormone receptor test for stages II through IV was associated with urban location and higher proportion of poorly insured patients (<i>R</i><sup>2</sup>=.18,<i>P</i>&lt;.00003); and (3) omission of indicated radiation therapy was associated with urban location and fewer breast cancer cases (<i>R</i><sup>2</sup>=.21,<i>P</i>&lt;.00001). Omission of adjuvant therapy and omission of axillary lymph node dissection were not significantly associated with any of the hospital variables examined. Conclusions. —The findings suggest that there is a group of urban hospitals, generally small and marginally reimbursed, where comprehensive diagnosis and treatment of breast cancer are not obtained. (<i>JAMA</i>. 1991;266:3429-3432)